Acute otitis media results from a complex interplay of host defenses, environmental factors, and virulence characteristics of bacteria. Previous studies suggest that Haemophilus influenzae (Hi), an important cause of acute otitis media in children, possess unique genes important in the pathogenesis of this infection. In this project, we will identify potential virulence factors specific for Hi otitis media. Using a subtractive hybridization technique, we will identify DNA fragments present in Hi otitis media isolates and absent in Hi throat isolates. The subtracted DNA fragments will be cloned, sequenced and used to determine their prevalence among large panels of Hi strains grouped by various epidemiologic parameters. Our large collection of Hi strains will be screened for the otitis media associated genes using a gene detection-based microarray consisting of genomes of the Hi strains and associations among these genes as well as between these genes and epidemiologic factors established. The Specific Aims of this project are: 1. Characterize Hi isolated from middle ear effusions of children with acute otitis media and from nasopharyngeal throat specimens of children by biotype, serotype, b-lactamase production and genotype by pulsed field gel electrophoresis. 2. Identify candidate Hi otitis media associated genes through subtractive hybridization. 3. Describe associations among candidate Hi otitis media associated genes and between Hi otitis media associated genes and epidemiologic parameters, including site of isolation, geographic location, persistence of nasopharyngeal colonization and ability to be transmitted child to child, using a microarray of Hi genomic DNA from each strain in our collections. 4. Characterize the Hi otitis media associated genes by size, predicted function, and location in the Hi chromosome. Identification of unique Hi otitis media virulence factors will facilitate the development of novel approaches to the prevention and treatment of Hi otitis media.